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Underuse of Cardiovascular Medications in Individuals With Known Lower Extremity Peripheral Artery Disease: HCHS/SOL
Simin Hua1, Carmen R Isasi1, Jorge R Kizer2,3
1Department of Epidemiology and Population Health Albert Einstein College of Medicine Bronx NY.
Insights
Cardiovascular medication use for peripheral artery disease (PAD) is low in Hispanic/Latino populations. Targeted interventions are needed to improve secondary prevention and clinical outcomes for this group.
Area of Science:
- Cardiology
- Public Health
- Health Disparities
Background:
- Underuse of cardiovascular medications for secondary prevention in peripheral artery disease (PAD) is a known issue.
- Limited data exists on PAD treatment in U.S. Hispanic/Latino populations, who face healthcare access barriers and poorer outcomes.
- This study addresses the treatment status of cardiovascular therapies in Hispanic/Latino individuals with PAD.
Purpose of the Study:
- To examine the prevalence of cardiovascular medication use in Hispanic/Latino individuals with PAD.
- To identify factors associated with cardiovascular medication use in this population.
- To compare medication use between individuals with PAD and those with PAD and coronary artery disease.
Main Methods:
- Analysis of 1244 Hispanic/Latino participants from the Hispanic Community Health Study/Study of Latinos.
- Comparison of antiplatelet, lipid-lowering, and antihypertensive therapy use based on PAD and coronary artery disease status.
- Multivariable regression models to assess factors associated with medication use, including demographics, acculturation, healthcare access, and comorbidities.
Main Results:
- Prevalence of antiplatelet, lipid-lowering, and antihypertensive therapy use in PAD patients was 31%, 26%, and 57%, respectively.
- Individuals of Mexican background showed the lowest medication use.
- Older age, more doctor visits, hypertension, and diabetes were associated with higher medication use. PAD with concurrent coronary artery disease increased likelihood of antiplatelet and statin use.
Conclusions:
- Hispanic/Latino individuals with diagnosed PAD significantly underuse guideline-recommended cardiovascular medications.
- Intervention strategies are crucial to enhance secondary prevention and improve cardiovascular health in this demographic.
- Addressing disparities in PAD treatment is essential for better health outcomes.
Abstract:
Background Underuse of cardiovascular medications for secondary prevention among individuals with peripheral artery disease (PAD) has been reported. Little is known about PAD treatment status in the Hispanic/Latino population in the United States, who may have limited access to health care and who have worse clinical outcomes than non-Hispanic individuals. Methods and Results We studied the use of cardiovascular therapies in 1244 Hispanic/Latino individuals recruited from 4 sites in the United States, including 826 individuals who reported diagnosis of PAD by physician and 418 individuals with coronary artery disease alone, in the Hispanic Community Health Study/Study of Latinos. We compared the prevalence of using antiplatelet therapy, lipid-lowering therapy and antihypertensive therapy by PAD and coronary artery disease status. Among those with PAD, we studied factors associated with taking cardiovascular medications, including demographic and socioeconomic factors, acculturation, access to health care and comorbidities, using multivariable regression models. The overall prevalence for individuals with PAD taking antiplatelet therapy, lipid-lowering therapy and, among hypertensive individuals, antihypertensive therapy was 31%, 26% and 57%, respectively. Individuals of Mexican background had the lowest use for all classes of cardiovascular medications. Older age, number of doctor visits and existing hypertension and diabetes mellitus were significantly associated with taking cardiovascular therapies in adjusted models. Compared with those with PAD alone, individuals with PAD and concurrent coronary artery disease were 1.52 (95% CI, 1.20-1.93) and 1.74 (1.30-2.32) times more likely to use antiplatelet agents and statins according to multivariable analysis. No significant difference of antihypertensive medication use was found among PAD patients with or without coronary artery disease. Conclusions Hispanic/Latino individuals with known PAD underuse cardiovascular medications recommended in clinical guidelines. More efforts should be directed to improve treatment in this important group.
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